Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC24053 | CA |
NPI | 1245311745 |
---|---|
Provider Name | Dr. Kenneth L Claborn |
First Address | Granada Hills, CA 91344-4629 |
Second Address | Granada Hills, CA 91344-4629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 02/07/2009 |